Repetitive Transcranial Magnetic Stimulation (rTMS)

About Repetitive Transcranial Magnetic Stimulation (rTMS)

It is a safe, alternative and effective, non-invasive neurostimulation treatment for patients suffering with depression who do not respond to antidepressant medications OR who cannot tolerate medication side effects.

rTMS therapy was approved by Health Canada in 2002 and represents the most significant innovation in neuropsychiatry over the last 50 years.

Approximately 50 to 55% of patients with treatment-resistant depression will experience a positive response to rTMS treatment, while remission rates are around 30 to 35% of patients.

To view an article about rTMS published in Psychiatric Times,click here.

How to get referred to the rTMS program?

Please note that we are currently accepting new patient referrals for the rTMS program from any geographic region.

If your doctor has recommended rTMS as a potential treatment for your depression, please have them submit a referral to the Adult Psychiatric Clinic at MDABC attn: Dr. Vila-Rodriguez. You do not need to be a patient of the Adult Psychiatric Clinic at MDABC to be referred for this treatment.

To access this referral form for your doctor to fill out, click here . Please ensure that they address it attn: Dr. Vila-Rodriguez so we know that it is for the rTMS program.

Once your referral has been received, one of our staff members will contact you to book you into a rTMS orientation session. These sessions occur on alternating Tuesdays from 10:00 am - 11: 00 am. This is an opportunity for you to ask questions regarding rTMS, and is mandatory prior to staff booking your consultation for rTMS with our specialist.

How does it work?

rTMS is a procedure in which an electromagnetic coil is placed against your scalp near your forehead. The electromagnet painlessly delivers a magnetic pulse that stimulates nerve cells in the region of the brain involved in mood control and depression. It may activate regions of the brain that have decreased activity in people suffering with depression. rTMS therapy involves a series of treatment sessions which typically last 4 to 6 weeks. Each treatment session is approximately 15 minutes and is administered 5 days a week. rTMS is not to be confused with ECT (Electro Convulsive Therapy)

What should I expect during the treatment?

Your treatment will be done sitting in a comfortable chair and you will be fully awake. rTMS does not require any sedation. The initial appointment will include a motor threshold test to determine the appropriate intensity of stimulation to be delivered for your treatment. A tapping sensation may be felt on the head during the procedure and may result in a mild headache due to the muscle stimulation on the scalp. Most people are usually able to resume regular activities following treatment.

Follow up appointments for rTMS

We are now booking follow up appointments for patients receiving rTMS treatment for depression and anxiety with Dr. Vila-Rodriguez. Follow-up appointments will be held in a group medical visit (GMV) fomat. This involves other patients being present during the appointment who are undergoing the same treatment. It is an opportunity to hear other patients' experiences and gain further knowledge about the treatment. Dr. Vila-Rodriguez will follow up with each patient during the visit and address questions and concerns. The GMVs will be held alternating Tuesdays from 10am-11am.

If you are interested in a follow up appointment regarding your rTMS treatment with Dr. Vila-Rodriguez, please call us at 604-873-0103 to book your appointment.

Tell your doctor if you are:

taking any medications, including over-the-counter medications, herbal supplements, vitamins and the doses

have a personal or family history of seizures / epilepsy

have other mental health disorders such as substance misuse, bipolar disorder or psychosis

have had brain damage from illness or injury, such as a brain tumor, stroke or traumatic brain injury

have frequent or severe headaches

have any other medical conditions

are pregnant or planning on becoming pregnant

Due to the strong magnetic field produced during rTMS, please advise Dr. Vila-Rodriguez if you have any metal or implanted mental devices in your body such as:

Aneurysm clips or coils

Stents

Implanted stimulators

Implanted vagus nerve or deep brain stimulators

Implanted electrical devices, such as pacemakers or medication pumps

Electrodes for monitoring brain activity

Cochlear implants for hearing

Any magnetic implants

Bullet fragments

Any other metal device or object implanted in your body

Side Effects

Side effects are minimal compared to the common side effects of antidepressant medication. They are generally mild to moderate and improve shortly after each individual session and decrease over time with additional sessions. They may include:

Headache

Scalp discomfort at the site of stimulation

Tingling, spasms or twitching of facial muscles

Lightheadedness

Serious side effects are rare. They may include:

Seizures (one in 1000 patients or 0.1% of patients)

Mania, particularly in people with bipolar disorder

Fees

Your consultation with the physician is covered by BC Medical Services (MSP). The treatment itself is not covered, however, before considering treatment, check with your health insurance company to determine if rTMS is covered.